Highest BP you have ever seen on a pt
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Hello,
I am new to all nurses as a poster. Have been looking at posts for a year or so.
Anyway, my coworkers and I were having a disscussion of the highest BP we have ever seen. We had a pt come... Read More

Jan 12, '07

Joined: May '04; Posts: 95; Likes: 15

I once had a patient with a bp of 230/130. Gave him 30mg of Nifedipine. Checked it 30 minutes later - 60/palp!!!!! I about had a heart attack. He was nonresponsive, bradycardic, etc... It ended up that he had some type of disorder that we didn't know about which made his BPs very labile. He didn't stroke out, and he was discharged later that day. Thank god. :uhoh21:

Just today a fellow student was telling us about a clinical day where her BP jumped out of contol. It was 256/180 and her hr was 235 or so. Clinical instructor did an EKG and would not let her go back to cinicals without seeing a cardiologist. She was told she had supraventricular tachycardia. She is fairly young and her normal BP is 95/60 or some ridiculously low #.

310/180s...a twenty-something dude that ingested several GRAMS of meth at a traffic stop instead of getting arrested (which he almost did anyway- one arrest for another.) His heart rate was somewhere in the 200s- 18 of ativan in about 20 minutes didn't begin to peel him off the ceiling.

Best WALKING blood-alcohol was .454 (just like a Chevy engine- odd the things we remember). Best overall BAC was .641- tubed but with spontaneous resps. He left AMA 4 days later out of the unit. Go figure.

On an ESRD patient in his left leg.....230/140. The nephrologist was an a*s of course....did not send him to the unit. Through the night after 0.7mg of Clonodine he finnally came down to the ultimate low BP of 200/100. The fun part about the whole story my other 6 patients were all renal patients all with the same nephrologist's group. I kept him up all night!!!!

On an ESRD patient in his left leg.....230/140. The nephrologist was an a*s of course....did not send him to the unit. Through the night after 0.7mg of Clonodine he finnally came down to the ultimate low BP of 200/100. The fun part about the whole story my other 6 patients were all renal patients all with the same nephrologist's group. I kept him up all night!!!!

Sorry, a little off subject here, but you just made me think of something...doncha just hate it when nurses or techs (who failed to tell you of an elevated BP) just kinda dismiss high BPs because "he's a renal pt". Really? Well no kidding that HTN kinda goes along with that - I guess we can just hasten his death by not worrying about it since it comes along with the territory?!? DUH!

And hey...what about the lowest blood sugar you've seen. I've seen 16 and the pt made it!

Jan 13, '07

Joined: Jan '06; Posts: 152; Likes: 21

Depends on if the "renal patient" is on dialysis or refusing dialysis

Jan 15, '07

Joined: Sep '06; Posts: 1

Tonight I got called to help set up BiPAP on a pt in fulminating cardiogenic pulmonary edema. He is unable to urinate and is not eligible for dialysis until tomorrow. When I entered his room, his monitor read 283/145(191). I didn't think it possible without CVA or other secondary comorbidity.

Jan 19, '07

Occupation: I work as a registered UK nurse in a multi-speciality icu unit. We recieve both general and neuro icu patients.
Specialty:
5 year(s) of experience
in
wards, recovery, icu.
;
Joined: Dec '06; Posts: 4

I'm a brit nurse working in Neuro-ICU so I've managed to witness some terrible BP's! Highest 310/190 Lowest 55/30! Of course we were all running for Labeterlol infusions for the high BP and Noradrenaline already running at high doses with the low BP.......Gelofusine at pressure and added vasopressor of Dopamine.....both patients survived!

Surprisingly, we get a lot of pts with VERY high BPs in the ER where I just started. Most just let their Rx's run out, a few days, weeks, etc., ago. 260/140, 189/130

Just a note on BP- I was pregnant with my first child and went to the clinic to start my visits and the nursing student taking my BP tries several times to get my BP and HR then scares the willies out of me by fetching his instructor. The instructor takes my BP and its 58/34 and my HR is 50 and the all important questions are: Are you active? How do you feel? I felt great and I was very active. The instructor explained to me and the student that this was a good thing. Too bad I'm not that active anymore

280/198 HR 140ish pt went about 280-290#, actually gave this pt nitroglycerin IV wide open- bolused a total of 125-150 ml of it before it and the 200mg of Lasix we gave him kicked in to help his foamating CHF.